1-SNP Form 1 Offeror Information Form.pdf

SNP Solicitation Form 1

Bidder Information Form

A. Bidder’s Identifying Information

Bidder’s Legal Name: ___________________________________________________________________

Bidder’s Trade Name: (if different from above): _______________________________________________

Bidder’s Legal Form (check one): ❏ Corporation ❏ Professional Corporation (“P.C”) ❏ Non-Profit Corp.

❏ Limited Liability Company (“LLC”) ❏ Partnership ❏ Limited Partnership❏ Limited Liability Partnership (“LLP”)

❏ Sole Proprietor ❏ Joint Venture ❏Other: __________________________________________________

Bidder’s Principal (Main Office) Address (Street. City, State, Zip)

Address of Bidder’s Anticipated Office for Providing Goods and/or Services in Response to this Bid (Street, City, State, Zip) (if different from Bidder’s Principal Office)

Federal Taxpayer I.D. No. e-Verify No.

Contact Person for This Bid Contact Person’s Position with Bidder

Contact Person’s Phone No. Contact Person’s Email

Bidder’s Anticipated Project Leader Project Leader’s Position with Bidder (if different from Contact Person)

Is Bidder registered to transact business with the Georgia Secretary of State? ❏ yes ❏ no

If yes, please provide Bidder’s current registration with the Georgia Secretary of State.

If Bidder is not registered to transact business with the Georgia Secretary of State, is it exempt from doing so and why?

How many years has Bidder been in the business of providing the goods and/or services requested by this solicitation?

If a Bidder is a Partnership, Limited Partnership, Limited Liability Partnership, or joint venture has been in business less than five years, it may be asked to provide a copy of its partnership or joint venture agreement and other documentation to satisfy the District that your business has the stability to provide the requested services. A failure to provide the requested information may result in the bidder being disqualified as non-responsive.

If Bidder is a Sole Proprietorship, the District may also request additional information to assess whether Bidder has the capacity to provide the goods and/or services requested, in the District’s sole discretion. For example, Based on SCCPSS SNP Template 4/12/25 the District may feel that sole proprietor has the capacity to provide trainings or repair specialized equipment, such as pianos. The District may not feel that a sole proprietor has the capacity to provide a service needed by all District schools every day of the school year. A failure to provide requested information may result in the bidder being disqualified as “non-responsive.”

What licenses does Bidder have to provide the goods and/or services requested by this solicitation?

License Type License Number (if Any) Confirm License is in Good Standing

Can Bidder satisfy the insurance requirements listed in this solicitation? ❏ Yes ❏ No

Please produce a certificate of insurance showing Bidder’s insurance coverage or letter from insurance broker confirming coverage can be provided to the District if it is awarded a contract.

If no, is Bidder partially insured or self-insured (or uninsured) for any of the types of insurance requested by this solicitation? Please explain why Bidder can provide adequate protections for the District?

Please note the District has discretion to determine whether a Bidder provides ample security if not fully insured.

B. How did Bidder learn of this solicitation?

It is the desire of the District to track the effectiveness of its advertising. Please let us know how Bidder learned of this solicitation. Please check all that apply:

❏ Georgia Procurement Registry ❏ Savannah Morning News

❏ SCCPSS.com ❏ The Savannah Tribune

❏ In-Person Visit to Purchasing Office

❏ Bonfire Procurement Platform

❏ Other _______________________________________________________________

C. Subcontractor Information

Does Bidder anticipate using any subcontractors on this project? If so, please identify. The District reserves the right to request any of the information requested of Bidder from a subcontractor

1. Company Name: __________________________________________________________________

Contact Person: __________________________________________________________________

Phone Number: ___________________________ FAX Number: ___________________________

E-Mail Address: ___________________________________________________________________

2. Company Name: __________________________________________________________________

Contact Person: __________________________________________________________________

Phone Number: ___________________________ FAX Number: ___________________________

If more than two subcontractors, please attach supplemental documentation.

D. Bidder’s References

Please provide references of at least three (3) organizations supplied with similar goods and/or services:

1. Company Name: __________________________________________________________________

Contact Person: __________________________________________________________________

Phone Number: ___________________________ FAX Number: ___________________________

E-Mail Address: ___________________________________________________________________

Dates of Service: ______________________________________________________________________

2. Company Name: __________________________________________________________________

Contact Person: __________________________________________________________________

Phone Number: ___________________________ FAX Number: __________________________

E-Mail Address: ___________________________________________________________________

Dates of Service: ______________________________________________________________________

3. Company Name: __________________________________________________________________

Contact Person: __________________________________________________________________

Phone Number: ___________________________ FAX Number: __________________________

E-Mail Address: ___________________________________________________________________

Dates of Service: ______________________________________________________________________

4. Company Name: __________________________________________________________________

Contact Person: __________________________________________________________________

Phone Number: ___________________________ FAX Number: ___________________________

Dates of Service: ______________________________________________________________________

E. Questions Regarding Responsibility of Bidder

Please answer the following questions regarding the criminal history, litigation history, and contract performance history of the Bidder and/or its officers, directors, owners, and other key employees who are expected to provide services to the District if the Bidder is awarded a contract as a result of this solicitation. Answers should be truthful, to the best knowledge of the Bidder’s representative submitting the Bidder’s response to this ITB and signed in the presence of a notary public.

If the answer to any of these questions is “yes,” then the Bidder should provide sufficient information for the District to identify the number and nature of the criminal offenses, administrative actions, lawsuits, or other potential contract performance issues disclosed.

If the number of criminal offenses, administrative actions, lawsuits, or other potential contract performance issues disclosed in response to each question is greater than zero (0) but fewer than five (5), then the Bidder should describe each issue identified with sufficient detail for the District to understand the nature of the offense, dispute, or performance issue, and the resolution, including the amount of any fine or judgment. In describing any legal matter in court, please provide the case name, case number, and court for each legal matter.

If the Bidder has more than five (5) criminal offenses, administrative actions, lawsuits, or other potential contract performance issues to disclose in response to each question, then the Bidder should state “more than five” and provide an explanation of why the matters to disclose exceed five (5) in number and why, in the opinion of the Bidder, the number and severity of these issues is not so significant as to adversely affect the Bidder’s ability to provide the goods and/or services requested in this solicitation. For example, some businesses may be so large and may be involved in such a large number of transactions that they are involved in numerous lawsuits throughout the country in the ordinary course of business, but the business is large enough that these lawsuits reflect only a small number of the company’s overall transactions and the business may be sufficiently insured and capitalized such that the volume of lawsuits may not pose any risk to the District. Similarly, financial institutions or large employers may be parties to a large number of garnishment actions involving their customers or employees. The business’s involvement in those types of proceedings does not reflect a track record of poor performance that would prevent the Bidder from competently providing the goods and services requested in this solicitation to the District.

The District may decide, in its sole discretion, whether the quantity or type of criminal offenses, administrative actions, lawsuits or other potential contract performance issues disclosed prevent the Bidder from being considered a “responsible” Bidder for this solicitation.

The District reserves the right to request additional information with respect to any answer to the following questions, including more specific information on any criminal matters or litigation disclosed. The District reserves the right to reject as “non-responsive” the Bid of any Bidder who refuses to provide any additional information requested by District staff to further inquire to any disclosures on this form.

To the extent the following questions request information with respect to an “owner” or “shareholder” of the Bidder, the question shall refer to the owner or shareholder of a privately held company, rather than a publicly traded company. The District recognizes that it may be impracticable for a publicly held company to know whether purchasers of publicly held stock have been involved in any responsive criminal proceedings or litigation.

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Questions

For purposes of this form, please answer questions as they apply to Bidder and any Related Party.

Related Party is defined as - any corporate affiliate of Bidder, any owner of more than 10% of Bidder’s ownership interests, any of Bidder’s current officers, any of Bidder’s current directors, or any of Bidder’s current employees that Bidder reasonably expects to be involved in actually providing goods and/or services to the District in response to this solicitation.

1. Please state whether Bidde or any Related Party, has ever been convicted of any criminal offense in connection with obtaining or attempting to obtain a government contract.

No Yes. If yes, describe:

2. Please state whether Bidder or any Related Party has ever been convicted of any criminal offense that would show a lack of business integrity or honesty, including, but not limited to embezzlement, theft, or fraud.

No Yes. If yes, describe

3. Please state whether Bidder or any Related Party, has ever been convicted of a felony under state or federal law, including, but, not limited to, murder, rape, or sexual assault.

4. Please state whether it has been determined, in the last five (5) years, that Bidder or any Related Party, has violated any state or federal labor laws, including but not limited to wage and hour or anti-discrimination laws, by 1) a government administrative agency responsible for administering such laws, such as the Department of Labor or the EEOC, or 2) as a result of the entry of a judgment in civil litigation brought by a government agency or private parties.

5. Please state whether it has been determined, in the last five (5) years, that Bidder or any Related Party, has violated state or federal occupational safety laws, including but not limited to OSHA regulations, by 1) a government administrative agency responsible for administering such laws, such as OSHA or 2) as a result of the entry of a judgment in civil litigation brought by a government agency or private parties.

6. Please state whether Bidder or any Related Party has ever been disbarred or otherwise disqualified from participating in any federal or state government purchasing process.

7. Please state whether Bidder or any Related Party, is currently a party in any civil litigation arising out its performance of a contract for the provision of goods and services, including, but not limited to, claims that Bidder breached that contract, caused personal injury or property damage in the course of its performance of the contract, or committed professional malpractice, regardless of whether the party bringing the claim was a party to the contract or a third party.

8. Please state whether, in the last five (5) years, any judgments have been entered against the Bidder or any Related Party, in any civil litigation arising out its performance of a contract for the provision of goods and services, including, but not limited to, claims that Bidder breached that contract, caused personal injury or property damage in the course of its performance of the contract, or committed professional malpractice, regardless of whether the party bringing the claim was a party to the contract or a third party.

9. Please state whether, in the last five (5) years, any local, state, or federal government agency has ever terminated a contract for cause with the Bidder or any Related Party.

10. Please state whether Bidder or any Related Party currently has or is seeking any other contracts with SCCPSS and state why Bidder believes it has the capacity to perform all of its contracts with SCCPSS simultaneously.

No Yes. If yes, describe:

F. Bidder’s Checklist

Receipt of Addenda:

In submitting this Bid, Bidder represents that they have received and examined the following Addenda:

Addendum 1_____________________ Date__________________________

Addendum 2 ____________________ Date__________________________

Addendum 3 ____________________ Date__________________________

Addendum 4 ____________________ Date__________________________

Addendum 5 ____________________ Date__________________________

Addendum 6 ____________________ Date__________________________

Addendum 7 ____________________ Date__________________________

Addendum 8 ____________________ Date__________________________

Forms and Supporting Documents:

___SNP Solicitation Form 1 Vendor Info Form ____ SNP Solicitation Form 2 Bid Exception Form

___SNP Solicitation Form 3 Lobbying Certificate _____SNP Solicitation Form 4 Debarment Certificate

______ SNP Solicitation Form 5 E-Verify Affidavit

____Any State of Georgia licenses required to provide the goods and/or services requested by this

ITB

______A copy of the Bidder’s Current Business License/Tax Certificate

______Bidder’s Certificate of Insurance: Documents showing that Bidder has or can obtain the minimum insurance required by this solicitation.

______A copy of the Bidder’s W-9, showing its Federal Tax Id. Number and Certification

_____Additional Documents Submitted by Bidder in Support of its Bid (see Attachment A):

It is essential that the submitted Bid complies with all the requirements contained in this ITB. The undersigned Bidder agrees, if this bid is accepted, to enter into an agreement with the School Nutrition Program on the form included in the Contract Documents to perform and furnish all products as specified or indicated in the contract documents.

In submitting this bid, Bidder agrees to the terms and conditions of the solicitation and to the following:

1. To hold my bid valid for a period of ninety (90) days.

2. To enter into and execute a contract, if awarded on the basis of this bid.

3. To accomplish delivery in accordance with the contract documents and specifications.

4. Payment Terms: Net 40

Delivery can be made within _________days after receipt of an authorized Purchase Order

Total Bid Price: $_____________________

G. Bidder’s Certification

Statement of Non-Collusion "I certify that this bid is made without prior understanding, agreement or connection with any corporation, firm or person submitting a bid for the same materials, supplies, or equipment, and is in all respect fair and without collusion or fraud. I understand that collusive bidding is a violation of State and Federal law and can result in fines, prison sentences, and civil damage awards. I agree to abide by all conditions of this bid and certify that I am authorized to sign this bid for the Bidder per O.C.G.A.50-5-67. I further certify that the provisions of the Official Code of Georgia annotated 45-10-20 et seq.

have not and will not be violated in any respect."

This is to certify that I, on behalf of the undersigned Bidder, have read this ITB in its entirety (including all attachments) and that the Bidder agrees to be bound by the provisions of the contained herein. I further affirm and attest under oath that the answers listed above are true to best of my personal knowledge.

This ____day of _____________________ 20 ___ By: ________________________________________

Name (printed) Title Signature Company Address (Street. City, State, Zip) Phone No. Fax No.

Federal Taxpayer I.D. No. e-Verify No.

Contact Person for This Bid Phone Number

Subscribed and sworn before me on

This the _____day of ___________________, 20_______

Notary public

My commission expires